In Reply: Mr Rottenberg discusses an important
issue regarding the likelihood of delivering chest compressions forceful enough
to press the sternum 38 mm to 51 mm. The rescuer’s physical strength
and endurance will be limiting factors, together with the team members’
understanding of how and when to change the person providing compression.
How to improve this performance has not been established. One method may be
to follow Mr Rottenberg’s suggestion that the rescuer should be no smaller
than the patient. Other methods may be to change the responder performing
compression every 1 to 2 minutes, to introduce prompts according to the quality
of chest compressions delivered, or to perform mechanical chest compressions.
Our research group is currently investigating the use of these methods to
increase the quality of chest compressions.